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Kerala Nurses on Strike

Nurses across the south Indian state of Kerala are on rolling strikes for pay increases against private hospitals which have been unwilling to meet the minimum wage demands of the state. Just as one strike ends (at SH Hospital in Paynkulam) another one begins (at Amrita Insitute of Medical Sciences). In many instances (like at Malankara Orthodox Syrian Church Medical College) nurses are winning their demands, in part because of the strength of the unions and in part because of the outpouring of support they are receiving from individuals everywhere. Despite demands of 85% increase in wages, throngs of people rallied in solidarity with the nurses.

The strikes were quite militant, causing hospitals in many instances to close down entirely. Even more astonishing has been the rapid growth of the nurses’ unions. Despite being relatively unorganized, the newly minted United Nurses’ Association has grown remarkably, adding over 400 branches in the first months of 2012. Part of the reason for this is clearly the conditions under which nurses labor. Despite the state’s fixed minimum wage at Rs. 9000, most nurses make barely half of that, and new “trainee” nurses make Rs. 1000 in some conditions.

Some of the issues faced by the nurses include the following. All hospital management says duty time is only 8 hour, but in reality this hardly the case with most of them made to work beyond the duty time. Most of the hospitals are not providing medical insurance or free health coverage especially given the fact that nurses are more prone to get diseases and infections. Many of the hospitals pay a very low wages, as low as Rs. 1800 a month (which is nowhere near even pathetic the labour minimum wages of around Rs. 6000). While hospitals charge patients anywhere from Rs. 1500-2500 (per day) as nurses fee but nowhere is this reflected in the nurses salary. Private/ corporate hospitals demand bonded contracts, which if broken, nurses are forced to pay more than Rs. 50,000. Even the so called ISO certified hospitals hire untrained nurses thus bringing down the wages of skilled nurses and putting the lives of patients at risk. Male nurses are denied opportunities often because of flimsy reasons, while they cleverly over exploit female nurses by under paying and over-exploiting them. Nurses are punished on flimsiest grounds, cuts in their salary or double duty time are rampant. Besides all these, none of them enjoy any basic rights as workers and are denied trade union rights. Moreover, many nurses are made to endure psychological abuses from the management.

The strikes in Kerala come on the heels of strikes that happened last year in Delhi, Bombay, and Calcutta, where similar conditions provoked industrial actions in hospitals there.

In February, hospitals demanded that the Kerala state government impose sanctions against nurses using the Essential Services Maintenance Act (ESMA) which requires certain necessary jobs continue during industrial disputes. The Kerala state government responded by accusing the hospitals of doctoring the books and misrepresenting nurses’ wages. Local courts, though, did provide hospitals with police to keep the nurses out and to keep operations going in some place.

The most puzzling part of the story has been the support from parties across the political spectrum. The CPI and CPM are not big surprises, nor are the Congress and the Congress-led INTUC (Indian National Trade Union Congress). But somewhat surprising are the BJP and the Shiv Sena, who declared hartals in support of the nurses. My best guess is that the massive popularity of the issue has meant that everyone has jumped on the bandwagon (though luckily this means that the nurses are likely to move from success to success even if this muddies the political waters in the long-term).